目的 探讨阳性激发点推拿联合依托芬那酯凝胶治疗对颈肩背肌筋膜炎的临床疗效。 方法 收集2011年2月－10月确诊为颈肩背肌炎的患者52例，采用随机对照试验,其中26例采用依托芬那酯凝胶加阳性激发点推拿（治疗组），另外26例采用传统推拿进行常规推拿手法治疗（对照组）。对两组患者5次治疗后的疗效率、每次治疗后的疼痛面谱量化评分、7个月后随访疼痛复发率等疗效进行对照分析。 结果 治疗组和对照组经连续治疗5次后，总有效率分别为96.15%和80.77%，差异均有统计学意义（P＜0.05）；疼痛面谱量化评分治疗组在第一次治疗后就较对照组改善明显，差异有统计学意义（P＜0.05）；7个月后随访疼痛复发人数治疗组较对照组少，差异有统计学意义（P＜0.05）。 结论 阳性激发点推拿联合依托芬那酯凝胶治疗方案对改善颈肩背肌筋膜炎引发的颈肩背部疼痛不适等症状优于传统推拿组，值得临床推广运用。
Drug-eluting stents have great impact to the coronary artery bypass grafting(CABG) in cardiac surgery. Someone even believes that it could replace the surgery procedure. However, the drug-eluting stents are not so ideally in the clinic practice. There are no significant difference between drug-eluting stents and bare metal stents in the mortality and the angina recurrence in middle-long term follow-up. The same results are in the compare with the CABG. As the challenge of the drug-eluting stents, the cardiac surgery has many aspects practice and progress in the harvest of the bypass graft. In the article, the change of the CABG conduit in the era of drug-eluting stents are reviewed.
目的 探讨加用网片盆底重建术（PROSIMA）治疗盆腔器官脱垂患者的围手术期护理方法。 方法 对2010年6月－2011年6月收治的23例盆腔脏器脱垂患者施行的PROSIMA护理措施进行回顾性总结。 结果 23例患者术后尿失禁症状明显好转，舒适感增加；仅1例发生尿潴留，予重置尿管后顺利排尿；治愈率达100%。术后6个月复查时均无阴道壁膨出或穹隆脱垂，未出现下尿路感染、网片侵蚀、下肢疼痛等并发症。 结论 有效的护理措施可减少PROSIMA术后并发症，对提高手术成功率、促进患者康复有明显作用。
Krüppel-like factor 4 (KLF4) is a member of the sample Kruppel transcription factor protein family, is an evolutionary conservative contain zinc finger transcription factors, involved in regulating many cellular processes, such as cell growth, proliferation, differentiation and invasion, KLF4 expression in a variety of tissues and cells in the body, has widely in many physiological and pathological conditions. Many studies have shown that KLF4 is involved in neurobiological processes such as neuroinflammation, oxidative stress, apoptosis and axon regeneration, and is closely related to a variety of nervous system diseases such as epilepsy, stroke, and Alzheimer’s disease. Now KLF4 in its role in the development of nervous system diseases were reviewed, help to understand the pathogenesis of the disease and clinical treatment for diseases of the nervous system to provide potential targets.
目的：总结汶川地震中骨折患者的康复治疗及其伤情分析，为灾难医学中骨折患者的康复治疗提供经验。方法：收集四川大学华西医院地震伤员康复中心的112例骨折患者资料，对伤情进行分析并对其康复治疗情况进行总结。结果：经康复治疗后患者的日常生活活动能力明显提高。结论：康复治疗对骨折患者非常重要。
ObjectivesTo systematically review the application of evidence-based medicine (EBM) combined with problem-based learning (PBL) method in clinical teaching.MethodsDatabases including WanFang Data, CNKI, VIP, CBM, PubMed and EMbase were searched to identify eligible randomized controlled trials that compared EBM plus PBL with traditional lecture based learning (LBL) method in clinical teaching from inception to March 28th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Statistical analysis was performed using Stata 14.0 software.ResultsA total of 33 randomized controlled trials with 2 855 students were included. The results showed that students in EBM combined with PBL group obtained better scores of specialized theory (WMD=6.87, 95%CI 5.08 to 8.66, P<0.001), skills examination (WMD=10.57, 95%CI 8.98 to 12.16, P<0.001) and case analysis (WMD=9.79, 95%CI 4.71 to 14.88, P<0.001), comparing with those in LBL group. Besides, EBM combined with PBL method improved students’ overall ability including independent learning capability, clinical thinking ability, problem-solving capability, literature exploring capacity, communication and presentation skills and team-work ability.ConclusionsApplication of EBM combined with PBL method can improve clinical teaching quality.
Objective To compare the sequential efficacy of high-flow nasal cannula oxygen therapy (HFNC) with non-invasive mechanical ventilation (NIV). Methods Randomized controlled trials comparing the efficacy of NIV sequential invasive mechanical ventilation with HFNC were included in the Chinese Journal Full-text Database, VIP Journal database, Wanfang Database, Chinese Biomedical Literature Database, PubMed, Cochrane Library and Embase. Meta-analysis was performed using RevMan5.4 software. Results A total of 2404 subjects were included in 19 studies. Meta-analysis results showed that compared with NIV, HFNC had a statistically significant difference in reducing patients' re-intubation rate in invasive mechanical ventilation sequence [relative risk (RR)=0.65, 95% confidence interval (CI) 0.50 - 0.86, Z=3.10, P=0.002]. HFNC showed statistically significant difference compared with NIV in reducing lung infection rate (RR=0.40, 95%CI 0.21 - 0.79, Z=2.67, P=0.008). HFNC was significantly different from NIV in terms of length of stay in Intensive Care Unit (ICU) (MD=–5.77, 95%CI –7.64 - –3.90, Z=6.05, P<0.00001). HFNC was significantly different from NIV in improving 24 h oxygenation index (MD=13.16, 95%CI 8.77 - 17.55, Z=5.87, P<0.00001). There was no significant difference in ICU mortality between HFNC and NIV (RR=0.70, 95%CI 0.45 - 1.08, Z=1.61, P=0.11). Conclusion Compared with NIV, sequential application of HFNC in invasive mechanical ventilation can improve the reintubation rate and pulmonary infection rate to a certain extent, reduce the length of ICU stay and improve the 24 h oxygenation index, while there is no difference in ICU mortality, which is worthy of clinical application.
ObjectiveTo analyze the clinical characteristics, risk factors, treatment and prognosis of epilepsy secondary to cerebral infarction.MethodsThe clinical data of 109 patients with epilepsy secondary to cerebral infarction admitted to the Affiliated Central Hospital of Shandong First Medical University from October 2018 to February 2021 were retrospectively analyzed, including the location of cerebral infarction, seizure type, seizure time and antiepileptic treatment.Results3 426 patients with cerebral infarction were treated in the same period, and the incidence of epilepsy secondary to cerebral infarction was 3.18%. Among 109 patients with epilepsy secondary to cerebral infarction, 71 were male and 38 were female, the average age was (67.42 ± 28.58) years. Time of seizure after cerebral infarction: 67 cases (61.47%) were early onset epilepsy and 42 cases (42.47%) were late onset epilepsy. The infarct site: 63.30% (69 /109) in cortex, 11.93% (13/109) in subcortical area, and 24.77% (27/109) in lacunar infarction secondary epilepsy. 5 cases died, the fatality rate was 1.59%, of which 4 patients died of early onset epilepsy, status epilepticus, and 1 patient died of late onset epilepsy due to acute cerebral infarction.ConclusionsIn patients with epilepsy secondary to cerebral infarction, the cortex is the most common site of infarction; focal seizures are more than comprehensive seizures; status epilepticus often indicates poor prognosis, so timely antiepileptic treatment should be given to improve the prognosis.
Esophageal cancer is a highly prevalent tumor species in Henan province, which brings heavy medical burden to families and society. Surgical treatment plays a dominant role in the treatment of non-advanced esophageal cancer. However, cancer cells in esophageal cancer lesions are highly invasive, postoperative recurrence and metastasis rates are pretty high. More effective systemic and comprehensive treatment is urgently needed to improve the prognosis. We invited 52 doctors in esophageal surgery, oncology, pathology, imaging, and radiation therapy of 32 hospitals at all levels in Henan province, to repeatedly negotiate and fully discuss in combination with evidence and clinical practice experience. Finally, “diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province” was formulated. In this treatment pathway, seven recommendations were proposed from seven perspectives including target population, patient evaluation, protocol selection, surgical timing, postoperative management, organ preservation, and general principles to offer reference for medical personnel related to esophageal cancer surgery.